E-Stim Tissue Healing & Contraction Flashcards
What occurs in the inflammation phase
Hemostasis
Autolysis
Phagocytosis
Fibroblastic migration
What occurs in the proliferation phase
Collegen synthesis
angiogenesis
epitheliazation
wound contraction
What occurs in the maturation phase
Collagen lysis
Collagen replacement
Factors that affect wound healing
Systemic med- aspirin, corticosteroids, indomethacin Topical meds Malnutrition presure/stretch infection immunodeficiency smoking necrotic/dry tissue
Common Places for a Pressure sore
sacrum, ischial tuberosity, greater trochanter, heel, malleoli
Stages of Pressure sores
Stage 1- nonblanchable erythema of intact skin
Stage 2- partial thickness skin loss to epidermis/dermis/both
Stage 3- full skin thickness loss affects subcutaneous
Stage 4- full skin thickness loss affecting mm./bone
Common places/Etiology of Arterial Insuf ulcers
lateral foot, on foot, toe joints, mallelio
arteriosclerosis, arterial occlusion/disruption
Common places/Etiology of Venous Insuf ulcers
above the ankle, medial lower leg
venous hypertension, venous valvular dysfunction
Common places/Etiology of Diabetic Ulcers
plantar foot, lateral foot, met heads, heel
neuropathy, arterial insuf
Electrochemical effects pos vs neg electrode
Negative electrode=alkaline
Positive electrode=acid
Electrophysical effects
electrokinetic-movement of ions
ie depolariziong of membrane
Electrothermal effects
microvibration to charge particles creating heat
H=0.24I2xRxT
I2=RMS
R=skin impedance
T=time
Effects that would benefit from wound healing
glavanotaxis collagen synthesis prolif of fibroblast angiogenesis bacteriacidal epitheliazation increase blood to wound
Galvanotaxis Inf phase consists of
macrophages- neg
neutrophils inactivated- neg
phagocytosis
autolysis
Galvanotaxis Prolif phase consists of
fibroblast- pos
collegen formation
Galvanotaxis Maturation phase consists of
myofibroblast-pos keratinocytes-pos epidermal cells-neg wound contraciton epitheliazation
Human battery pos vs neg
outside=neg
inside=positive
switches with injury
Protocol 1
cathode to site for 1-5 days
Protocol 2
cathode- ecoli
anode-aueras
Protocol 3
anode-attract macrophages/neutrophils for autolysis/phagocytosis
cathode- attracts fibroblast/myofibroblast for wound contraction/epitheliazation, granulation
Protocol 4
cathode- liquefy/soften tissue, soluble
anode- stimulate epetheliazation
Cathode- neg effects and its Galvanotaxis cells
increase blood flow
increased growth of granulation
epidermal cell migration
anti microbial
Galvanotaxis:fibroblast, neutrophisl, platelets, lymphocytes, mast cells, keratinocytes
Anode- pos effects and its Galvanotaxis cells
decrease blood flow
vasoconstriction
decrease mast cells during tissue healing
growth/re-organization of epithelial cells
anti microbial
Galvanotaxis: macrophages, neurtrophils inactivated, epidermal cells
Neg pole theory
repel negatively charged serum proteins
decrease microvessel diameter
decrease pore size
Voluntary contraction vs. E-stim contraction
voluntary
small slow MU recruited first
asynchronous MU recruited
E-stim
large fast MU recruited first
fast fatigue muscle, requires more rest time
synchronous MU recruitment
Factors affecting Force-Frequency
mm length
mm temperature
fatigue state
degree of potentiation
E-stim required for twitch, contration, tetanus
follows arndt schultz law, must be strong/long/rise enough
low freq=1-2 stim per second for twitch
med freq=15 pps for contraction
>30 for tetanus
Strength MVIC Training
to strength train healthy mm via e-stim, must stim at 50% of MVIC
to strengthen injuried mm via e-stim, must stim at 10% of MVIC
Overload Theory
larger load placed on a muscle, the muscle will produce a greater contraction =strength will increase more than if smaller load on muscle
Specificity Theory
should produce greater strength gains than exercise alone at same contraction force
E-stim can also do this to Innervated muscles
high frequency e stim increases blood flow back to heart in healthy/pt
reduces stress incontinence
E-stim on denervated muscles
DC current stims the mm membrane NOT the nerve/neuron
> 10ms of pulse duration=contraction
use with caution, may retard motor nerve regeneration
Contraindications of Russian Currents
anterior c-spine
trans cranial region
trans thoracic region
abdominal/lumbar of pregnant women
hemorrhaging area
neoplasm
decreased sensation in area
electrical/metal implants
